Health-law advocates fear effect of repeal

With Republicans set to take control of Ohio and the U.S. House of Representatives, patient advocates say they are worried about the future of health-care reform.

With Republicans set to take control of Ohio and the U.S. House of Representatives, patient advocates say they are worried about the future of health-care reform.

Many Republicans who ran for Congress campaigned on a platform to repeal the law or at least not fund parts of it when elements come up for congressional approval. But any cuts or changes to health reform would have to survive a Democratic Senate and would risk a veto by President Barack Obama.

Still, Ohio Attorney General-elect Mike DeWine promised in his campaign to join a multistate lawsuit challenging the constitutionality of the federal law.

Health reform, which became law in March, aims to insure 32million Americans who are uninsured. It also has eliminated lifetime caps on policies and the ability of health-insurance plans to deny coverage to people with pre-existing medical conditions.

"We're in a race against time because the more the public understands the benefit of health-care reform, the less support there will be for outright repeal," said Cathy Levine, executive director of the Universal Health Care Action Network of Ohio. "More importantly, the Affordable Care Act is not a partisan law. It's become a political football, but today's controversial policies were actually first supported by Republicans."

That includes, Levine said, the mandate that will require all Americans to have health insurance or pay a penalty. The multistate suit that DeWine plans to join challenges that mandate.

If that suit is successful and the mandate is eliminated, pieces of health-care reform that the public supports - such as coverage for people with pre-existing conditions - will disappear, said Jeff Biehl, executive director of Access HealthColumbus.

"The only way to guarantee coverage is to guarantee that everyone is required to get into the game," Biehl said.

The law is like a stool about to lose a leg, and when one leg is gone, the stool can no longer stand, Levine said.

Still, Republicans are vowing to keep their word to stop health reform.

"You're going to see us move to deal with Obamacare, and you will see us do it rather quickly," said U.S. Rep. John Boehner, R-West Chester, on Cincinnati's WKRC-AM radio last week. "I believe that Obamacare will ruin the best health-care delivery system in the world, and I think it will bankrupt our country.

"That's why we pledged to repeal Obamacare and replace it with common-sense reforms to bring down the cost of health care, and that's exactly what we will do."

The big financial piece of the reform law is the expansion of the Medicaid program by 2014. That would give coverage to about 200,000 central Ohio residents, Biehl said.

But if those people stay uninsured, those who are insured can expect to pick up their health-care costs in rising premiums, experts say. Biehl said more than $1,000 of a family-policy premium goes toward the cost of health care for the uninsured.

The law also earmarks $11billion for community health centers to handle more patients, said Thomas Horan, chief executive of the Columbus Neighborhood Health Center Inc. Of the 24,000 people who go to Columbus clinics each year, 15,000 are uninsured, he said.

"The $11 billion will have an impact, but it will not meet the coverage gap out there for so many people," Horan said. "We're just waiting to see what they're going to look at and proposed changes they're going to make."

In the meantime, state officials are moving ahead with health-care reform. Their efforts include creating a health-insurance exchange in which consumers can buy affordable policies starting in 2014.

"It is the federal law, and insurance companies have to comply, and they're looking to the state insurance department to implement the law, and that will remain true with the new administration," said Doug Anderson, chief policy officer at the Ohio Department of Insurance.

shoholik@dispatch.com

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